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Study Objectives: <p>In addition to sleep duration, sleep timing is another important but significantly understudied sleep characteristic that may be closely associated with cardiovascular disease (CVD) mortality. To investigate optimal sleep timing, we assessed the associations of sleep timing with all-cause and CVD mortality in a large sample of older adults.</p> Methods: <p>This prospective cohort study included 18,129 adults (median age = 65 years) from Guangzhou Biobank Cohort Study, recruited during 2008–2012 and followed up until July 2022. Participants’ sleep timing (early, intermediate, and late) was defined by the midpoint between bedtime and wake time. Four CVD susceptibility single-nucleotide polymorphisms were used to calculate the genetic risk score.</p> Results: <p>During a median follow-up of 12.4 years with 213,534 person-years, 2,997 deaths occurred. Compared with the intermediate group, both early and late midpoint groups were associated with a higher risk of all-cause mortality (adjusted hazard ratio = 1.18, 95% confidence interval = 1.07–1.30; and adjusted hazard ratio = 1.13, confidence interval = 1.01–1.26, respectively). Restricted cubic spline curves indicated U-shaped associations of sleep at midpoint, bedtime, and wake time with all-cause and CVD mortality (all <i>P</i> for nonlinearity &lt; .05), with the lowest risk observed at approximately 2:30 <span>am</span>, 11:00 <span>pm,</span> and 6:00 <span>am</span>, respectively. The associations of early and late sleep timing with risk of all-cause mortality were more pronounced in males, older people, and those with a high CVD genetic risk score.</p> Conclusions: <p>For the first time, we identified U-shaped associations of sleep timing with all-cause and CVD mortality by identifying the specific sleep timing points associated with the lowest mortality risk, explicitly from 11:00 <span>pm</span> to 6:00 <span>am</span>.</p> Citation: <p>Wang J, Li YR, Jiang CQ, et&#xa0;al. Optimal sleep timing revealed: a new perspective on reducing all-cause mortality and cardiovascular disease-cause mortality in older adults. <i>J Clin Sleep Med</i>. 2025;21(10):1709–1722.</p>

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Optimal sleep timing revealed: a new perspective on reducing all-cause mortality and cardiovascular disease-cause mortality in older adults

  • 期刊论文

  • 发表日期：

    2025年10月1日

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  • Jiao Wang,
  • Ying Ru Li,
  • Chao Qiang Jiang,
  • Wei Sen Zhang,
  • Tong Zhu,
  • Feng Zhu,
  • Ya Li Jin,
  • Tai Hing Lam,
  • Kar Keung Cheng,
  • Lin Xu

摘要

Study Objectives:

In addition to sleep duration, sleep timing is another important but significantly understudied sleep characteristic that may be closely associated with cardiovascular disease (CVD) mortality. To investigate optimal sleep timing, we assessed the associations of sleep timing with all-cause and CVD mortality in a large sample of older adults.

Methods:

This prospective cohort study included 18,129 adults (median age = 65 years) from Guangzhou Biobank Cohort Study, recruited during 2008–2012 and followed up until July 2022. Participants’ sleep timing (early, intermediate, and late) was defined by the midpoint between bedtime and wake time. Four CVD susceptibility single-nucleotide polymorphisms were used to calculate the genetic risk score.

Results:

During a median follow-up of 12.4 years with 213,534 person-years, 2,997 deaths occurred. Compared with the intermediate group, both early and late midpoint groups were associated with a higher risk of all-cause mortality (adjusted hazard ratio = 1.18, 95% confidence interval = 1.07–1.30; and adjusted hazard ratio = 1.13, confidence interval = 1.01–1.26, respectively). Restricted cubic spline curves indicated U-shaped associations of sleep at midpoint, bedtime, and wake time with all-cause and CVD mortality (all P for nonlinearity < .05), with the lowest risk observed at approximately 2:30 am, 11:00 pm, and 6:00 am, respectively. The associations of early and late sleep timing with risk of all-cause mortality were more pronounced in males, older people, and those with a high CVD genetic risk score.

Conclusions:

For the first time, we identified U-shaped associations of sleep timing with all-cause and CVD mortality by identifying the specific sleep timing points associated with the lowest mortality risk, explicitly from 11:00 pm to 6:00 am.

Citation:

Wang J, Li YR, Jiang CQ, et al. Optimal sleep timing revealed: a new perspective on reducing all-cause mortality and cardiovascular disease-cause mortality in older adults. J Clin Sleep Med. 2025;21(10):1709–1722.